Pembrolizumab-induced nonischemic cardiomyopathy: a case report of a rare immune-related adverse event.

ABSTRACT:

Background

Immune checkpoint inhibitors (ICIs) have improved survival in advanced cancers but may cause immune-related adverse events (irAEs). Cardiovascular irAEs, though rare, can be fatal, with myocarditis as the most serious manifestation. While typically occurring early in therapy, late-onset cases are increasingly recognized. We report a rare case of pembrolizumab-induced myocarditis complicated by severe cardiomyopathy and left ventricular (LV) thrombus.

Case description

A 63-year-old woman with stage IV lung adenocarcinoma on pembrolizumab-based therapy presented with chest pain and elevated troponin. Echocardiography suggested Takotsubo cardiomyopathy, and coronary angiography revealed no obstruction. Ten days later, she returned with worsening chest pain, markedly

SUBMITTER: Bahar AR 

PROVIDER: S-EPMC12593073 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature